Held in both hands, carefully move account book (6)
I believe the answer is:
ledger
'account book' is the definition.
(synonyms)
'held in both hands carefully move' is the wordplay.
'held in' is an insertion indicator.
'both hands' becomes 'LR' (abbreviations for left and right).
'carefully move' becomes 'edge' (to edge is to move along slowly).
'lr' going around 'edge' is 'LEDGER'.
(Other definitions for ledger that I've seen before include "Account book" , "Old-fashioned heavy accounts book" , "In which accounts are entered" , "record-holder" , "Accounts journal" .)